| NPI | 1407186687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02004716A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 05-43229) |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2023-09-26 |